Supporting existing kiritaki (clients) through the transition
On Sunday 1 December 2024, we go live with our new Sensitive Claims Service contract. As we move to the new contract, it’s important that existing kiritaki (clients) can continue receiving the treatment and services they need. Below is some guidance for how you can support kiritaki through the move from the Integrated Services for Sensitive Claims (ISSC) to the new Sensitive Claims Service.
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Transition period
We have set up a transition period from 1 December 2024 until 31 May 2025. This is to allow for kiritaki to be transitioned to the new Sensitive Claims Service contract at the next check-in or reporting point. This is to ensure continuity of care and a positive experience through the transition period (by managing the flow of kiritiaki over to the new service).
Once kiritaki have transitioned to the Sensitive Claims Service, any ISSC services or Training for Independence programme they were receiving on their sensitive claim must end. From that point forward, any support kiritaki need must be delivered under the Sensitive Claims Service contract.
What we need from you
To support the effective transition of kiritaki between contracts, we need existing suppliers and providers to consider how you can best support kiritaki through the transition.
Determine what will be needed to support kiritaki receiving services under your ISSC contract. Some questions to consider are:
- Am I intending to continue to deliver services under the Sensitive Claims Service contract? This will determine the approach you will need to take to transition kiritaki.
- If I am not intending to provide services under the Sensitive Claims Service contract, can I continue to support existing kiritaki to complete services between 1 December 2024 – 31 May 2025, or do I need to consider when to transition kiritaki to a new supplier and/or provider before 1 December 2024?
- When do I expect existing kiritaki to conclude services; will this be before 1 December 2024? If not, when would a transition point be for kiritaki i.e. when is my existing purchase order finished?
The next step is to use the Sensitive Claims Service transition guide below to work through how kiritaki will be moved to the new contract.
This transition guide is a tool for existing Integrated Services for Sensitive Claims (ISSC) suppliers and providers to support kiritaki as they move from the ISSC to the new Sensitive Claims Service.
All suppliers who currently hold an ISSC contract are responsible for managing kiritaki being supported under their contract to move to the Sensitive Claims Service.
This guide offers steps you can take to support kiritaki depending on your specific scenario. The goal is to ensure kiritaki can continue to receive the treatment and services they need as we move to the new contract.
While this guide covers the most common scenarios, there may be some scenarios that are not covered. If after using the guide, providers need additional guidance, they must consult with their supplier. If further support is required:
- See our frequently asked questions about transition document.
- Contact us:
Email ISSCevolution@acc.co.nz
Queries about transition must come through this avenue rather than directly to our Recovery Team members.
Transitioning from Support to Wellbeing Long Term (ISSC) into a Tailored Support to Wellbeing Package B (Sensitive Claims Service)
When kiritaki transition from Support to Wellbeing Long Term under the ISSC, this does not mean they will be automatically given a full allocation of Tailored Support to Wellbeing Package B under the new Sensitive Claims Service contract.
At the ‘transition point’ the supplier and lead service provider will be required to submit a new Wellbeing Plan (on the new Sensitive Claims Service report template) that sets out the recovery goals and request for services.
As part of the new Wellbeing Plan, the lead service provider will need to consider what services kiritaki have already received under the ISSC and what further services are required to support kiritaki to achieve their recovery goal/s (and over what period, up to a maximum of up to 24 months).
- One allocation of Tailored Support to Wellbeing Package B is available on receipt of the new Wellbeing Plan (on approval of that plan). The new Wellbeing Plan must confirm the hours and services required within the parameters of the Package that are required to support kiritaki to meet their recovery needs.
- If services cannot be completed within the provision of that package approved by ACC, kiritaki would be able to access one additional allocation of Package B as per the Sensitive Claims Service contract. Further services after this would require a treatment review.
- One allocation of Tailored Support to Wellbeing Package B is available on receipt of the new Wellbeing Plan (on approval of that plan). The new Wellbeing Plan must confirm the hours and services required within the parameters of the Package that are required to support kiritaki to meet their recovery needs.
- If services cannot be completed within the provision of that package approved by ACC, kiritaki will not be automatically able to access one additional allocation of Package B.
- ACC will contact the lead service provider three (3) months prior to the completion of the agreed package to confirm:
- if kiritaki are on track to complete this service, or
- a treatment review is required to assess the further needs of kiritaki.
Following confirmation of the above, ACC will confirm the next steps with the supplier and the lead service provider. The supplier will undertake the confirmed next steps as soon as practicable.
- One of the goals in the new Wellbeing Plan must be for a treatment review to be completed within six months of acceptance of the Wellbeing Plan (unless services will be completed within that six months).
- ACC will allocate a purchase order that has:
- six months of services (no more than 25 hours)
- a treatment review (that includes up to six hours to complete sessions and 10 hours to review and write up the treatment review report).
- The treatment review must be completed within the six-month period from when the purchase order is issued.
- On receipt of the treatment review, we will review and confirm the next steps.
Purchase orders and other key information
Below is some additional guidance on:
- the cut off dates for purchase orders
- group-based therapy
- outcome measures
- administrative and management fee
- engagement forms
- Training for Independence
- No new purchase orders will be issued beyond Friday 30 November 2024 for the ISSC or Training for Independence Sensitive Claims TI-SC contracts.
- All purchase orders that need to be approved or amended must be requested before Wednesday 20 November 2024. This is to allow sufficient time for them to be issued before Friday 30 November 2024.
- We will honour existing purchase orders (issued prior to Friday 30 November 2024) under the current ISSC contract or Training for Independence Sensitive Claims TI-SC contract up until 31 May 2025 (or earlier).
- Any purchase orders dated Sunday 1 June 2025 and beyond cannot be honoured. Therefore, you will now start to see purchase orders with an end date of Saturday 31 May 2025 rather than for 12 months.
- For any purchase orders issued for ISSC Support to Wellbeing Long Term hours, the allocation of hours will be prorated at a rate of one hour per week (e.g. for four months of support, we would approve 16 hours of service, equating to one hour per week).
- For any purchase order with ISSC support services, the allocation of hours will be prorated (eg for 6 months of social work, 5 hours will be approved).
- When kiritaki transition to the Sensitive Claims Service, the non-attendance fee allocation available under the ISSC is void. A new allocation of non-attendance fees as per the Sensitive Claims Service contract will be available under a new purchase order.
- From now on, no new applications to deliver group-based therapy (including groups for Dialectical Behavioural Therapy – DBT) will be accepted. Existing approved groups can complete services if the supplier and provider are able to deliver that service through the transition period (Sunday 1 December 2024 to Saturday 31 May 2025).
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Suppliers must confirm the dates for existing approved groups by 31 October 2024. After this date, ACC will not accept requests to amend approved groups, including updating the confirmed dates those groups will run.
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In circumstances where kiritaki transition to the Sensitive Claims Service but are still participating in ISSC approved group-based therapy, ACC will honour existing purchase orders, and you will be required to invoice using the ISSC service codes for group-based therapy and the Sensitive Claims Service codes for other services until the conclusion of the group.
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Kiritaki cannot access group-based therapy through both the ISSC and Sensitive Claims Service during the transition period.
- Applications for group-based therapy (including DBT) under the new Sensitive Claims Service contract will open in February 2025.
- New outcome measures will be used and collected when kiritaki transition to the Sensitive Claims Service (as per the requirements of the Sensitive Claims Service contract).
- Details about the new outcome measures and how they will be collected are available in the Operational Guidelines.
- When kiritaki transition to the Sensitive Claims Service, the lead service provider will receive an email prompt from ACC to start the new outcome measures. After this, collection of outcome measures will follow the schedule outlined in the Operational Guidelines.
From 1 December and during the transition period, the administration and management fee under the Sensitive Claims Service contract can be invoiced for when:
- new kiritaki (who have never received services under either the ISSC or new Sensitive Claims Service); engage in the Sensitive Claims Service after 1 December 2024
- kiritaki move to a new supplier under the Sensitive Claims Service, or
- kiritaki return to services with the same supplier after 24 months from when the previous engagement form was lodged (this includes where they were previously engaged in services under the ISSC).
The administration and management fee cannot be invoiced when:
- kiritaki transition to the Sensitive Claims Service with the same supplier that supported them under the ISSC contract, or
- where kiritaki have been engaged in services for more than 24 months.
- When kiritaki transition from the ISSC to the Sensitive Claims Service, a new engagement form is only required if kiritaki are transitioning to a new supplier.
- If kiritaki are continuing with their current supplier, a new engagement form is not required, even if they are changing lead service providers. If kiritaki are changing lead service providers, notify the ACC Recovery Team supporting the kiritaki with confirmation of the new provider.
- Kiritaki cannot receive Training for Independence Sensitive Claims services at the same time as similar services under the Sensitive Claims Service (such as physiotherapy or occupational therapy).
- If the kiritaki is receiving a TI-SC programme, ACC will notify the supplier and lead service provider of the end date of this programme.
- Further services should only be requested under the Sensitive Claims Service after this end date, to ensure they are still required for the kiritaki.
At a glance: transitioning kiritaki
For new kiritaki accessing services after 1 December 2024
All new kiritaki accessing services for the first time will be supported under the new Sensitive Claims Service contract from 1 December 2024.
For kiritaki being supported under the existing ISSC contract
There will be a transition period from 1 December 2024 to 31 May 2025. There are several scenarios that are possible through this period.
Where suppliers and providers intend to continue to deliver services under the Sensitive Claims Service contract
We will work with suppliers and providers to transition existing kiritaki to services under the new Sensitive Claims Service contract at the next check-in or reporting point in the recovery plan for the kiritaki (subsequently referred to as 'transition point'). This will include confirming services and hours available through a new purchase order.
Where suppliers and providers do not intend to deliver services under the new Sensitive Claims Service contract
We will honour existing purchase orders (approved prior to 30 November 2024) under the current ISSC contract up until 31 May 2025. This is to allow for either the planned completion of services; or to support kiritaki to transition to a new provider delivering services under the new Sensitive Claims Service.
No further services will be purchased under the existing ISSC contract from 30 November 2024.
For suppliers and providers that intend to stop delivering services after 1 December 2024, you will need to advise us as soon as possible and support the transition of any kiritaki you are working with to a new supplier and/or provider once the outcome of the tender is confirmed in September 2024.
Where a supplier is intending to deliver services under the Sensitive Claims Service contract, but a provider isn’t
As a supplier, you will need to ensure all kiritaki receiving services under your ISSC contract have been transitioned to another provider if their current provider is not intending to deliver services under the new Sensitive Claims Service contract from 1 December 2024.
Kiritaki must be involved in choosing another provider. There needs to be a handover process or meeting between the two providers to ensure a seamless transition for kiritaki.
Continuity of service for kiritaki is paramount during this time. Suppliers are expected to consent to the movement of kiritaki where this is required and provide support through that move.
During the transition period it is important that you have and can implement your business continuity and transition plans to ensure kiritaki can continue to be supported with as little disruption to their care as possible.
As a provider, you will need to work with your supplier to support the transition to another provider.
Where a provider is intending to deliver services under the new Sensitive Claims Service contract, but their supplier isn’t
As a provider, it is important that you are confirmed and named on a new supplier’s contract before 4 October 2024 so you can commence service delivery on 1 December 2024 under the new Sensitive Claims Service contract.
As a supplier, you will need to ensure all kiritaki receiving services under your ISSC contract have been transitioned to another supplier who will be delivering services under the new Sensitive Claims Service contract from 1 December 2024.
This will mean supporting your existing provider/s to change suppliers and agreeing to the transfer. Kiritaki must be informed and agree to the change of supplier.
You will still need to contact our Recovery Team managing the claim via email requesting the transfer, with confirmation that the requirements above have been met and when the transfer needs to occur.
We expect existing suppliers that are not intending to deliver services under the new contract to support the release of providers and kiritaki to new suppliers as required.
Understanding the new service: guidance for kiritaki
With talk of a new contract, kiritaki may have questions about the new Sensitive Claims Service and what it means for them. To help you have conversations with kiritaki about the new service, please see our guidance document and frequently asked questions. You can direct kiritaki to this resource if they have questions and want to learn more about the new service.